ArticleThe Pan African medical journal2025
Cytokines in HIV-1 patients on combination antiretroviral therapy with persistent low-level viremia at a tertiary hospital in Western Kenya.
Article in The Pan African medical journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: persistent low-level viremia (pLLV) in HIV-1 participants on combination antiretroviral therapy (cART) is a significant predictor of immune activation and virologic rebound. Elevated cytokine levels are linked to pLLV, yet the roles of pro- and anti-inflammatory cytokines remain unclear in settings such as Kenya. This study assessed IL-17, IFN-γ, IL-10, and TGF-β in HIV-1 pLLV and virally suppressed participants at Moi Teaching and Referral Hospital (MTRH) to explore alternative biomarkers for virologic monitoring in resource-limited settings. Methods: cross-sectional study of 82 age- and gender-matched HIV-1 participants on first-line cART, -41 pLLV (50-500 copies/ml), and 41 virally suppressed (<50 copies/ml) was conducted using MTRH database data. Plasma cytokines (IL-17, IFN-γ, IL-10, TGF-β) were measured by ELISA (Zeptometrix, USA), and viral loads by RT-PCR (Abbott, USA). Data were analyzed using Mann-Whitney U, Chi-squared, and logistic regression tests. Results: the median (IQR) levels of IL-17, IFN-γ, IL-10, and TGF-β (pg/ml) were significantly higher in pLLV participants on first-line cART compared to virally suppressed participants: 23.8 (21.3-25.8) vs. 15.5 (12.7-18.2); 28.3 (23.5-31.2) vs. 11.4 (8.8-14.8); 45.2 (34.0-53.7) vs. 28.4 (22.6-31.6); and 56.9 (50.0-67.8) vs. 27.7 (19.5-34.7) p<.001. The odds (95% CI) of being suppressed were reduced by TGF-β 0.329 (0.035-0.361), IFN-γ, 0.360 (0.270-1.501, and IL-17 0.938 (0.691-1.273), but increased by IL-10 1.106 (0.675-1.811), though not statistically significant. Conclusion: persistent low-level viremia (pLLV) presents with elevated pro-inflammatory (IL-17, IFN-γ) and anti-inflammatory cytokines (IL-10, TGF-β) levels. Recommendation: exploring other cytokines in pLLV could enhance understanding of cytokine levels and viral suppression and may help refine HIV-1 treatment.
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